As well as complying with first aid requirements, the pharmacy team also needs to be able to deliver it, says Victoria Goldman…

In October 2021, a YouGov survey revealed that over a third of UK adults have never had any form of training to learn essential cardiopulmonary resuscitation (CPR) skills.

The annual Restart a Heart campaign aims to train people in how to perform CPR, so they feel confident to act in an emergency. The campaign is led by Resuscitation Council UK, in partnership with St John Ambulance, the British Heart Foundation, the British Red Cross and all UK ambulance services.

For every minute that a person in cardiac arrest doesn’t receive CPR and defibrillation, their chance of survival drops by up to 10 per cent, so acting in an emergency is crucial.

According to the General Pharmaceutical Council (GPhC),¹ the public expects a pharmacist to be able to help if there’s an accident or emergency near the pharmacy or in the pharmacy itself. People see a pharmacist as an appropriate person to phone for advice in an emergency. Therefore, someone working the pharmacy team should know how to perform first aid.

First aid training

Health and Safety Executive (HSE) First Aid at Work guidance² states that there must be a suitably stocked first aid kit in the workplace, as well as an appointed person (or people) to take charge of first aid arrangements, and information for all employees telling them about these arrangements.

The appointed person is responsible for looking after the equipment, facilities and calling the emergency services. They must always be on the premises whenever people are at work.

There are no specific rules on how many trained first aiders a pharmacy needs to have, and every pharmacy will decide this for themselves. The Red Cross has produced a guide³ to first aid at work, including choosing first aiders and finding a suitable first aid course.

The HSE strongly recommends that first aiders have annual refresher training, over half a day, during any three-year certification period. This isn’t mandatory but will help qualified first-aiders to maintain their basic skills and keep up to date with any changes to first-aid procedures.

As a minimum, according to the GPhC, pharmacy first aid training should cover:

• obstruction to airways
• CPR
• shock
• electric shock
• overdoses and poisoning
• a seizure
• hypoglycaemia or hyperglycaemia
• loss of consciousness
• severe bleeding
• burns and scalds
• head injuries and concussion
• severe pain in head, chest or abdomen
• allergic reactions.

First aid training should also cover, as a minimum:

• minor allergic reactions
• foreign bodies or chemicals in the eye
• mild shock
• minor burns and scalds
• injuries to bones, muscles, joints
• minor bleeding.

First aid kit supplies

While community pharmacies might stock and sell first aid equipment, it’s important to have a dedicated first aid kit on the premises to be used by employees in an emergency. According to the HSE, the contents of a workplace first aid kit should be based on a first aid needs assessment. When buying a ready-made kit, the pharmacy team should look for British Standard (BS) 8599.

A minimum first aid kit for environment where the risks of injuries is relatively low may contain:

• a leaflet with general guidance on first aid
• individually wrapped sterile plasters of assorted sizes
• sterile eye pads
• individually wrapped triangular bandages, preferably sterile
• safety pins
• large and medium-sized sterile, individually wrapped, unmedicated wound dressings
• disposable gloves.

All first aid kits should be checked regularly to replace out-of-date equipment and replenish dwindling supplies. Many sterile products have an expiry date, or the manufacturer will have guidelines on how long an item can be kept to make sure it is still fit for purpose.

Responding to emergencies

Many deaths could be avoided by taking first-aid action early on. If someone is injured, the first step is to check that they (and everyone around them) aren’t in any immediate danger, and to make the situation safe before dialling 999 for an ambulance.

It’s important to carry out basic first aid while waiting for an ambulance to arrive. Advice is available online from the NHS website, the Red Cross and St John Ambulance on how to deal with various situations, such as anaphylaxis, heavy bleeding, burns and scalds, choking, drowning, fractures, heart attack, poisoning, shock and stroke.

As general guidance:⁴

• If someone is unconscious and breathing and has no other injuries that would stop them being moved, place them in the recovery position until help arrives. Keep them under observation to ensure they continue to breathe normally.
• If someone is unconscious and not breathing, or not breathing normally, call 999 and start CPR straight away.

Assessing an injured person involves checking their airway, breathing and circulation. If a person is unresponsive, ask them if they’re OK and if they can open their eyes. If they can respond, leave them in the position they’re in until help arrives, while checking their breathing, pulse and level of response regularly.

If there’s no response, leave them in the position they’re in and open their airways. This involves placing one hand on their forehead and gently tilting their head back, lifting the tip of their chin using two fingers. This moves their tongue away from the back of their throat. Don’t push on the floor of the mouth, as this will push the tongue upwards and obstruct the airway.

To check if a person is still breathing, look to see if their chest is rising and falling, listen over their mouth and nose for breathing sounds, and feel their breath against your cheek for 10 seconds.

If they’re breathing normally, place them in the recovery position and continue to monitor normal breathing. If they’re not breathing or aren’t breathing normally, call 999 for an ambulance and then begin CPR.

First aid courses

St John Ambulance (www.sja.org.uk/courses/workplace-first-aid/)

Red Cross (www.redcrossfirstaidtraining.co.uk/courses/first-aid-at-work-courses-uk-mainland/)

First Aid for Life (https://firstaidforlife.org.uk)

First Aid for All (https://firstaidforall.uk), with a specific course for pharmacists and pharmacy students

Online First Aid (https://onlinefirstaid.com)

References

1. https://www.pharmacyregulation.org/medicines-and-health
2. https://www.hse.gov.uk/simple-health-safety/firstaid/first-aid-training.htm
3. https://resources.redcrossfirstaidtraining.co.uk/download-complete-guide-to-first-aid-at-work
4. https://www.nhs.uk/conditions/first-aid/